Musculoskeletal injury and ergonomics in pediatric gastrointestinal endoscopic practice

Wenly Ruan; Catharine M Walsh; Swati Pawa; Sharlene L D'Souza; Promila Banerjee; Shivangi Kothari; Graham A McCreath; Douglas S Fishman

doi:10.1007/s00464-022-09455-9

Musculoskeletal injury and ergonomics in pediatric gastrointestinal endoscopic practice

Surg Endosc. 2023 Jan;37(1):248-254. doi: 10.1007/s00464-022-09455-9. Epub 2022 Aug 3.

Authors

Wenly Ruan¹, Catharine M Walsh², Swati Pawa^{3

4}, Sharlene L D'Souza⁵, Promila Banerjee⁶, Shivangi Kothari⁷, Graham A McCreath⁸, Douglas S Fishman⁹

Affiliations

¹ Section of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, 6701 Fannin Street, D1010.18, Houston, TX, 77030, USA. wenly.ruan@bcm.edu.
² Division of Gastroenterology, Hepatology, and Nutrition, and the Research and Learning Institutes, Hospital for Sick Children,, Department of Paediatrics and the Wilson Centre, University of Toronto, Toronto, ON, Canada.
³ Section of Gastroenterology and Hepatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
⁴ Bill Hefner VA Healthcare System, Salisbury, NC, USA.
⁵ Gasteroenterology Consultants, Medford, OR, USA.
⁶ Loyola Stritch School of Medicine and Edward Hines Jr Veterans Administration Hospital, Hines, IL, USA.
⁷ University of Rochester Medical Center, Rochester, NY, USA.
⁸ The Hospital for Sick Children, SickKids Research Institute, Toronto, ON, Canada.
⁹ Section of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, 6701 Fannin Street, D1010.18, Houston, TX, 77030, USA.

PMID: 35920909
DOI: 10.1007/s00464-022-09455-9

Abstract

Background and aims: Endoscopy-related musculoskeletal injuries (ERI) are increasingly prevalent in adult endoscopists; however, there are no studies that have evaluated ERI and ergonomic practices among pediatric gastroenterologists and trainees. We aimed to examine the prevalence, nature, and impact of musculoskeletal injuries in pediatric endoscopic practice and assess attitudes towards ergonomic training needs.

Methods: Pediatric gastroenterologists and trainees were surveyed to collect information on endoscopist and practice characteristics, the prevalence, nature, and impacts of ERI, ergonomics strategies employed in practice, previous ergonomics training, and perceptions of ergonomics training (elicited using a 1 (strongly disagree) to 5 (strongly agree) Likert scale). Responses were analyzed using descriptive statistics, and bivariate analyses were conducted to explore correlates of ERI.

Results: Among 146 survey respondents, 50 (34.2%) were trainees and 96 (65.8%) were practicing endoscopists with a mean duration of endoscopic practice of 9.7 ± 9.4 years. Overall, 55.6% (n = 80/144) reported experiencing a musculoskeletal injury, with 34.7% (n = 50/144) reporting an injury attributable to endoscopy. Among those with ERI, the most common sites were the neck/upper back (44.0%), thumb (42.0%), hand/finger (38.0%), and lower back (36.0%). Women were more likely to experience ERI compared to men (43.4% vs. 23.4%; p = 0.013). Only 20.9% of participants had formal training in ergonomics. Respondents reported being motivated to implement practice changes to prevent ERI (4.41 ± 0.95) and perceived ergonomics training as important (4.37 ± 0.96).

Conclusions: Pediatric endoscopists, and particularly women, experience significant ERI; however, formal endoscopy ergonomics training is rare. Improved ergonomics training is needed for both practicing pediatric gastroenterologists and trainees.

Keywords: Ergonomics; Musculoskeletal injury; Pediatric endoscopy.

MeSH terms

Adult
Child
Endoscopy, Gastrointestinal / adverse effects
Ergonomics
Female
Humans
Male
Musculoskeletal Diseases* / epidemiology
Musculoskeletal Diseases* / etiology
Musculoskeletal Diseases* / prevention & control
Occupational Diseases* / epidemiology
Occupational Diseases* / etiology
Occupational Diseases* / prevention & control
Occupational Injuries* / epidemiology
Surveys and Questionnaires